08-105639 3uilding - Commercial
City of Federal Way Q w
Community Development Services Permit #: 08-105639-00-CO
P.O.Box 9718
Federal Way,WA 98063-9718
Inspection Request Line: (2
53)(253)835-2607 Fax (253)835-2609 p Q 835-3050
Project Name: VIRGINIA MASON MEDICAL CENTER-ORTHO CLINIC
Project Address: 33501 1ST WAY S Suite 220 Parcel Number: 926504 0010
Project Description: TI-Tenant improvement to a 4352 sqft space on the 2nd floor to become an orthopedic
clinic.Work to include construction of new interior partition walls,suspended ceiling grid.
No mechanical or plumbing on this permit.
Owner Applicant Contractor Lender
VIRGINIA MASON CLINIC COLLINS WOERMAN G L Y CONSTRUCTION INC VIRGINIA MASON CLINIC
1100 9TH AVE 710 SECOND AVE SUITE 1400 GLYCOI*01809 (9/30/10) 1100 9TH AVE
SEATTLE WA 98101-2756 SEATTLE WA 98104-1710 PO BOX 6728 SEATTLE WA 98101-2756
BELLEVUE WA 98008-0728
Census Category: 437 - Commercial alt/add/conversion
Includes: #1 #2 #3 #4
Occupancy Class: B
Construction Type:
Occupancy Load:
Floor Area(sq.ft.) 4,352 0 0 0
'a
n
5.
Existing Sprinkler System in Building? Yes Mechanical to be Included? No
Number of Stories 2 Permit for Building Shell Only? No
Plumbing to be Included? No New/Additional Sq.Feet-Total 0
Occupancy#1 -Use Professional Sensitive Areas?(Wetlands/Slopes,etc) No
Services/Offices
Zoning Designation OP
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PERMIT EXPIRES Monday, August 3, 2009 °
Permit Issued on Wednesday, February 4, 2009
I hereby certify that the above information is correct and that the construction on r='`above described property and
the occupancy and the use will be in accordance with the laws, rules and reg ='” s of the State of Washington
and the City of Feder- Way.
Owner or age �— — _ la e: O/y/-,244:5,
1111111.F if
y City of Federal Way • `
Certificate of Occupancy
This Certificate issued pursuant to the requirements of Section 110.2 of the International Building Code certifying that
at the time of issuance, this structure was in compliance with the various ordinances of the City regulating building
construction or use. This certificate is valid ONLY when endorsed by City staff.
Tenant Name: VIRGINIA MASON MEDICAL CENTER- ORTH Permit#: 08-105639-00-CO
Address: 33501 1ST WAY S Suite220
Includes: #1 #2 #3 #4
Occupancy Class: B
Construction Type:
Occupancy Load:
Floor Area(sq. ft.) 4,352 0 0 0
Owner Name: VIRGINIA MASON CLINIC
0 • •r Address: 1100 9TH AVE
AT ►LE W 98101-2756
'F., • , /r I% - 4-2-4- a�
But ding Official Date
The priority focus in the review and inspection made by the City prior to issuance of this Certificate was on those matters which
experience has shown most severiy affect the health and safety of the general public. Although the City has made as complete a
review and inspection as is reasonably possible(within budgetary time and personnel limitations), the City neither guarantees nor
warrants to the owner/occupant or to any other person that this Certificate evidences strict compliance with each and every
ordinance or regulation of the City or the State of Washington affecting the construction or use of said structure or the land upon
which it is situated. Such compliance is the responsibility of the owner and/or occupant of the premises.
r r a
DATE INSPECTOR AREA AND TYPE OF IWECTION ' -
2?.3- cxl c.w S 6,5, e._1'/.;45 6DdfaC�49.r 4 3
• THIS CARD IS TMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 08-105639-00-CO
Owner: VIRGINIA MASON CLINIC
Address: 33501 1ST WAY S Suite 220
FEDERAL WAY, WA 98003
This card is part of your required inspection documents. Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD.
Inspections are listed as close to sequential order as possible(read left to right,top to bottom). Please schedule inspections as appropriate. Work must not
be covered until it is approved. Check with your inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections
are logged on the back of this card.
0 Footings/Setback(4110) 0 Re-steel(4215) ❑ Slab/Concrete Floor(4255)
Approved to place concrete Approved to place concrete or grout Approved to place concrete
By Date By Date By Date
1
El Underfloor Framing(4285) ❑ Floor Sheathing(4105) 0 Fire/Draft Stops(4095)
Approved to sheath floor Approved to install flooring Approved
By Date By Date By Date
NOTE: Prior to scheduling a Framing(4120) ❑ Framing(4120) ❑ Insulation (4150)
inspection;Electrical,Plumbing&Mechanical Approved to insulate Approved to install wallboard
Rough-in and Fire/Draft Stop inspections must be
signed-off and approved. IBC 109.3.4/UBC 108.5.4 ^�1
By W Date 2.21 Byi75 Date 3_s-,..09
.❑ Gypsum Wallboard Nailing(4130) ❑ Suspended Ceiling Grid (4265) ❑ Final-Fire Department(4060)
Approved to install mud&tape Approved to drop tile Approved
By---(5 Date 3_cam ect By ,' fi✓ Date y/-3. 0? By DM Date l�.z q -4,
❑ Final-Planning(4070) ❑ Final-Building(4050)
Approved Approved
By Date By ....t., ..\ Date V. ZC,CJ
•
For inspector reference only
0 Rough Electrical 0 FINAL-Electrical
Approved Approved
By Date By Date
, • III fe- i o - 2
C,�oF �E!�EIVE — — - � �
Federal Way ®PERMIT
COMMUNITY DEVELOPMENT SERVICES SF MF CO E EL PL DE EN FP
33325 8TH ALA SOUTH.PO 63971 9718 Ana,PLICATION
FEDERAL WAY,FAX
53063-260 TU /oil 253-835-2607•FAX 253-835-2609
www.cittioffecleralwau.com
CITY OF FEDERAL WAY
The following is required inforn6'Qigrn-an incomplete application will not be accepted. Please print legibly(in ink)or type.
• PROPERTY INFORMATION/ �/ �J
SITE ADDRESS_ 3370/ /9 ' 1/�f� 'Y:1?W r e f fe11� i i/I /�O79 SUITE/UNIT# � 2Zd
ASSESSOR'S TAX/PARCEL# ! 2- 10 �J _ - �0 f d LOT SIZE(sfi
tars I,z,3,y,SG OD 7 W((1 ,WIyf Offief fite r D/d/%/M'/*We.5.74/raeo/AfG
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) To THE par 1I/E:ei l PEIo€PiP/N✓oLM#ff ill, OFPieX/PA4e4271A/ne,497 AO,
(Attach separate page for lengthy legal description)
��• PROJECT INFORMATION
TYPE OF PERMIT IB BUILDING ❑ PLUMBING 0 MECHANICAL
0 DEMOLITION ❑ ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlu)
i
G6/�Y/G J.r/i N 0G�,(AX4#/44/p hp/. d/ov, 70A#fs/Y p,Qo jFFr', rawer
4,e;7, /li ide,ex.)9,:e.7- 7 viralip4( ',v.L/,Eovis GO i, G��r rl/fl/7
PROJECT NAME(Name of Business or Owner Last Name) V/e ' '/,1 / I&v/V /11 /'" 1 L- i/`1�_
• PEOPLE INFORMATION
PROPERTY NAME�i ,J�� �/ ,/�y / / /�,�/4PRIMARY PHONE
OWNER t//0 0//N7f®!�' ///106,1 !/�%/i'/li� (5•41,4)fl -Oea
MAILING ADDRESS CITY,STATE,ZIP E-MAIL ADDRESS
CONTRACTOR COMPANY NAME APPLIrC T NAME OFFICE PHON
6 i.Y Co 0,e/e710, ri f /M /M" (44.1)519" /177
/'v MAILING FI (J�f�� C��L�7,�i!/ of 9�OD!/ `ELL PHONE -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE (FAX NUMBER
50-ea-/W1,11-DD-,G /23/ZOO/ ( ) -
CONTRACTOR'S REGISTRATION NUMBER IRATION DATE E-MAIL ADDRESS
NYGOI 'D/Be Ot7/50%/0 ! ��, - ',_ - , • o
APPLICANT COMPANY NAME APPLICANT AME OFFICE PHONE
JMAILING ADDRESS CELL PHONE
Dorn,//Gt���ill, �A j� -/ (Zol��sNs' 2082.
7/ORELATIONSHIP O4 d %/K//� Hot° -CCITYfr.7 � Wei FAX NUMBER
0 Architect 0 TenaTO nt 0 Agent o Other ( ) -
PROJECT NAME PRIMARY PHONE// AAE-MAI DRES
CONTACT ��fl'/Q/� ��G (1'69)7'f` -ft/i l/fe/GOceiSdinigd1Y1 ed/yf
LENDER NAME/- (/t /' Per RCW 19.27.095:
/R 'V Lender information is required if project value exceeds$5,000
MAILINd ADD S CITY,STATE,ZIP PHONE
�/ / • DETAILED BUILDING INFORMATION
EXISTING USE /k��ikp ilia PROPOSED USE �,��®,��7/e e6hve
EXISTING ASSESSED/APPRAISED//VALUE$ VALUE OF PROPOSED WORK $ teaapO
SPRINKLERED BUILDING? (YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDEREHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER AKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC)
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND �/A /�
THIRD (ff!,
ADDITIONAL FLOORS(DESCRIBE)
DECK(❑COVERED OR ❑UNCOVERED?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTAL=STING sF TOTAL PROPOS sP TOTAL SF
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
• FIXTURES
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WI1 H APPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
ktBOILERS FIREPLACE INSERTS HOODS(commercial)
.
COMPRESSORSFURNACESRANGES
DUCTS GAS LOG SETS REFRIG.SYSTEMS
�\ PLUMBING
BATHTUBS(or Tub/Shower Combo) LAVS(Bathroom Sinks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS(Toilet)
\ ELECTRIC WATER HEATERS SINKS WASHING MACHINES
`�� HOSE BIBBS SUMPS
SIGNATURE
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the best of my
knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply with all applicable
City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the issuance of this permit
does not remove the owner's responsibility for compliance with local,state,or federal laws regulating construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim(including costs, expenses, and attorneys'fees incurred in the
investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the city, but only
where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the information supplied to
the city as a part of this app attiiioonn.
SIGNATURE: �2��qh%� %j2- DATE // /GI tl08
Property Owner and/or Authorized Agent /
❑NEW o ADDITION ❑ALTERATION ❑REPAIR TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑YES SNO BASIC PLAN? ❑YES 5eN0
ZONING DESIGNATION 0 CHANGE OF USE? ❑YES ,l(NO
NEW ADDRESS REQUIRED? ❑YES r NO UP/SEPA/SU? ❑YES ` NO
PLATTED LOT? •YES ❑NO DEMO PERMIT REQUIRED? ❑YES f O
Bulletin#100—January 1,2008 Page 2 of 4 k\Handouts\Permit Application